What that's meant for Steve Hall, health officer at the Central Michigan District Health Department, is having to continually “shift on the fly.” For example, when Governor Gretchen Whitmer announced that residents 65 and older would become eligible to get their shots, Hall learned that his department would stop receiving Moderna shipments. So, he put in an order for Pfizer doses, but without having secured access to the necessary cold freezer storage. “Thankfully we have a great relationship with [Central Michigan University] and they offered up [their ultra-cold freezer], so we certainly took them up on that offer,” he said. Other rural health officials agree that being responsive and looking for local support will guide them though the uncertainty.